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Job Application

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Fields marked with an asterisk (*) must be filled out before submitting.

Basic Information

First Name *
Middle Name
Last Name *
Suffix (if applicable)

Contact Information

Email Address *
Your Address (if outside US, please include country) *
Daytime Telephone *

References

Reference 1 – Full name *
Reference 1 – Job title *
Reference 1 – Company name *
Reference 1 – Phone number *
Reference 1 – Email *
Reference 1 – What is your relationship with this person? *
 
Reference 2 – Full name *
Reference 2 – Job title *
Reference 2 – Company name *
Reference 2 – Phone number *
Reference 2 – Email *
Reference 2 – What is your relationship with this person? *
 
Reference 3 – Full name
Reference 3 – Job title
Reference 3 – Company name
Reference 3 – Phone Number
Reference 3 – Email
Reference 3 – What is your relationship with this person?

Work Status

Are you legally authorized to work in the United States? * Yes
No (I would need sponsorship)

Uploads

Maximum upload size for ALL files combined: 100MB
PDF Files Preferred.
Resumé or CV *

Voluntary Self Identification

Carnegie Institution of Washington is an equal opportunity employer and committed to fostering a diverse workforce. It is our policy to administer all personnel actions including recruiting, hiring, training. and promoting employees without regard to race, color, religion, sex, sexual orientation, national origin, age, disability, marital status, veteran status, or any other legally protected classification in accordance with applicable federal and state laws.

Consistent with the obligations of these laws, Carnegie Institution of Washington will make reasonable accommodations for qualified individuals with disabilities. In addition, as a federal government contractor, the Institution maintains an affirmative action program which furthers its commitment and complies with record keeping and reporting requirements under certain federal civil rights laws and regulations, including Executive Order 11246. Section 503 of the Rehabilitation Act of 1973 and the Vietnam Era Veterans’ Readjustment Assistance Act of 1974, as amended.

As part of our compliance with these obligations. the Institution invites you to voluntarily self-identify as set forth below. Provision of the following information is entirely voluntary and a decision to provide or not provide such information will not have any effect on your employment or subject you to any adverse treatment. Any and all information provided will be considered confidential, will be kept separate from your application and/or personnel file. and will only be used in accordance with applicable laws, orders and regulations, including those that require the information to be summarized and reported to the federal government for civil rights enforcement purposes.

If you choose not to volunteer your information, you must select “I prefer not to provide this information” below. Do not leave blank.
SELF ID: Ethnicity-Are you Hispanic/Latino? (If yes then you should select -I prefer not to provide this information- on the race section below.) * Yes
No
I prefer not to provide this information.
SELF ID: Race (See definitions below.) * American Indian or Alaskan Native (Not Hispanic or Latino)
Asian (Not Hispanic or Latino)
Hawaiian or Pacific Islander (Not Hispanic or Latino)
Black or African-American (Not Hispanic or Latino)
White/Caucasian (Not Hispanic or Latino)
Two or more Races (Not Hispanic or Latino)
I prefer not to provide this information
SELF ID: Protected Veteran Categories (See definitions on following page, please check all that apply) * I am not a Veteran
Disabled Veteran
Recently Separated Veteran
Armed Forces Service Medal Veteran
Active Duty Wartime or Campaign Badge Veteran
I prefer not to provide this information
SELF ID: Gender * Male
Female
I prefer not to provide this information

Ethnicity:

Hispanic or Latino – A person having origins of Cuban, Mexican, Puerto Rican, Central or South American or other Spanish culture or origin, regardless of race.

Race:

American Indian or Alaskan Native – A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment.

Asian – A person having origins in any ofthe original peoples of the Far East, Southeast Asia, or the Indian subcontinent, including. for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

Native Hawaiian or Other Pacific Islander – A person having origins in any ofthe peoples of Hawaii, Guam, Samoa, or other Pacific Islands.

Black or African American – A person having origins in any of the Black racial groups of Africa.

White/Caucasian – A person having origins in any of the original peoples of Europe, the Middle East or North Africa.

Protected Veteran Categories:

Disabled Veteran – A veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs, or a person who was discharged or released from active duty because of a service-connected disability.

Recently Separated Veteran – a veteran during the three-year period beginning on the date of such veteran’s discharge or release from active duty in the U.S. military, ground, naval, or air service.

Armed Forces Service Medal Veteran – A veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

Active Duty Wartime or Campaign Badge Veteran – A veteran who served on active duty in the U.S. military, ground, naval or air service during a war or in a campaign or expedition for which a campaign badge has been authorized, under the laws administered by the Department of Defense.

Voluntary Self-Identification of Disability

Why are you being asked to complete this form?

Because we do business with the government, we must reach out; to hire, and provide equal opportunity to qualified people with disabilities. i To help us measure how well we are doing, we are asking you to tell us if you have a disability or if you ever had a disability. Completing this form is voluntary, but we hope that you will choose to fill it out. If you are applying for a job, any answer you give will be kept private and will not be used against you in any way.

If you already work for us, your answer will not be used against you in any way. Because a person may become disabled at any time, we are required to ask all of our employees to update their information every five years. You may voluntarily self identify as having a disability on this form without fear of any punishment because you did not identify as having a disability earlier.

How do I know if I have a disability?

You are considered to have a disability if you have a physical or mental impairment or medical condition that substantially limits a major life activity, or if you have a history or record of such an impairment or medical condition.

Disabilities include, but are not limited to:

  • Blindness
  • Deafness
  • Cancer
  • Diabetes
  • Epilepsy
  • Autism
  • Cerebral Palsy
  • HIV/AIDS
  • Schizophrenia
  • Muscular dystrophy
  • Bipolar disorder
  • Major depression
  • Multiple sclerosis (MS)
  • Missing limbs or partially missing limbs
  • Post-traumatic stress disorder (PTSD)
  • Obsessive compulsive disorder
  • Impairments requiring the use of a wheelchair
  • Intellectual disability (previously called mental retardation)

Reasonable Accommodation Notice

Federal law requires employers to provide reasonable accommodation to qualified individuals with disabilities. Please tell us if you require a reasonable accommodation to apply for a job or to perform your job. Examples of reasonable accommodation including making change to the application process or work procedures, providing documents in alternate format, using a sign language interpreter, or using specialized equipment.

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i Section 503 of the Rehabilitation Act of 1973, as amended. For more information about this form or the equal employment obligations of Federal contractors, visit the U.S. Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) website at www.dol.gov/ofccp

PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. This survey should take about 5 minutes to complete.

SELF ID: Disability * Yes, I have a disability (or previously had a disability)
No, I don’t have a disability
I prefer not to answer

Read Carefully Before Submitting

I certify that the information I have provided to the foregoing questions is true and correct, and no attempt has been made to conceal pertinent information. I authorize my former employers, school, and business references to provide any information they may have regarding me, whether or not it is in my records. I hereby release them and their company from all liability for divulging same. I understand that all statements made are open to investigation by Carnegie Institution of Washington and that if any information given by me in this application, is found to be false or misleading, I will be subject to dismissal at anytime during the period of employment and I agree to hold the Carnegie Institution of Washington and persons named herein blameless in the event.

I understand that this employment application and any other Carnegie Institution of Washington documents are not contracts of employment; therefore, under proper notice, I may voluntarily leave the Institution at any time and, likewise, the Carnegie Institution of Washington may at any time terminate my employment, and that any oral and written statement to the contrary are not binding and, therefore, should not be relied upon.

Please confirm * I agree to the above statements.
 

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